Healthcare Provider Details

I. General information

NPI: 1598689226
Provider Name (Legal Business Name): CHRISTOPHER JAIME
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6618 W MOHAVE ST
PHOENIX AZ
85043-5737
US

IV. Provider business mailing address

6618 W MOHAVE ST
PHOENIX AZ
85043-5737
US

V. Phone/Fax

Practice location:
  • Phone: 602-842-2897
  • Fax:
Mailing address:
  • Phone: 480-372-6458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: